by Sid Holt
I’ve spent my entire life being told I’m a reactive person.
Every situation a catalyst for a fiery explosion, a shower of multicolored sparks like the rockets we used to shoot off at the dunes when I was in high school, arcing high into the darkness before inevitably falling down and away, dying out amongst the whitecaps. People say “reactive” but they don’t mean that, not really. They mean difficult, unpleasant, short, hard to deal with, temperamental, too much. They mean these things in unkind, unpleasant ways but it is hard to take them poorly when sometimes I am the only one saying the things that need to be said. Plain truths are difficult, not the people saying them, but for a long time I believed the people who said these things, that there was something twisted and wrong in me.
When you’re mentally ill, many people like to attribute everything about you to your mental illness; if I wasn’t crazy, maybe I wouldn’t be so challenging—as though my mental illness shapes every element of my personality and I am simply pulled along in its wake, unable to make conscious decisions about the person I want to be and how I want to carry myself in the world. They think my mental illness sidles up to me on benches and murmurs, and I do its bidding, holding its hand as it pushes me out into traffic. I must be kept quiet, safe, calm, sane, through chemistry.
“Are you off your meds?” they might ask.
Often, it’s a kind of blame. Sometimes it’s a well-intentioned excuse, as though they are in the position to determine when my behavior needs to be excused and they’re doing me a favor.
But I know true reactiveness, because I have felt it inside my own body—a runaway chain of events that felt wildly uncontrollable and irrational. Experiencing a severe reaction to medication taught me many interesting things about the limits of my own body, but also the limits of the world around me, because it brushed up against some uncomfortable truths about psychiatric medications that many people would rather not discuss—to wit, that they have side effects, and “side effects may include” can apply to anyone and everyone. Pharmaceutical companies are eager to help people overlook that information, rattled off at warp speed in commercials and provided in small print on packaging, but desperation can be a powerful driver too—the willingness to risk anything to make what is hurting you stop. So too can the earnest desire to do good, to encourage people to use medications if they find them helpful, to avoid discussing some of the costs of doing so.
Many of our worst associations with psychiatric medications originate from the moment the pharmaceutical industry first started developing them in force, in the mid-1900s. Powerful antipsychotic drugs that nearly incapacitated patients became the stuff of nightmares and pop cultural lampooning—the drooling, shuffling, slack-jawed “psych patients” depicted in media of that era made a strong impression, as do the calls for haloperidol on contemporary emergency room dramas, turning a screaming, thrashing patient into a compliant, dull-eyed one in minutes. Later classes of drugs have tempered those extreme side effects, designed to allow people to live a full life, not just sedating them into oblivion—but for some patients, the level of sedation can be much higher, by design or happenstance, and it becomes unbearable, creating fog and fatigue that makes it impossible to function.
As ever, the dose makes the poison.
Medication is one among a number of ways to manage mental health conditions and for some of us they can be highly effective, helping us live with, instead of fight, our minds—cultivating space to inhabit the world more fully. It is also deeply stigmatized, intriguingly from almost every imaginable social perspective. Taking meds means you’re weak. Taking meds means you’re suppressing your body’s natural expression. Taking meds means you’ll forget your “real” self. Taking meds means you’re a tool of big pharma. Taking meds means you’ll get dependent and you’ll be stuck on them for life. Taking meds means you’re not trying hard enough—you should do more yoga, drink more kombucha, go to more crystal healings, think yourself well. Taking meds means you’re poisoning yourself. Taking meds is a concession to centuries of psychiatrization and abuse of mentally ill people, abuse that continues to this day.
Wait, that last one is actually somewhat true.
The movement to be more open about mental health, to confront, as people say, “the stigma,” has had a profound impact on what it means to be mentally ill in America, especially for those of us with severe mental illnesses—commonly defined as mental illnesses that cause “serious functional impairment” that interferes with daily life, like some forms of bipolar disorder, schizophrenia, and major depression. People are much more open than they used to be. Social media has become a treasure trove of resources. For those with severe mental illness, this is a more fraught experience, one with much higher risks, one that makes them hesitant to be outspoken about their mental health conditions, though that, too, is beginning to shift due to works like Esmé Weijun Wang’s The Collected Schizophrenias.
And so has the conversation about medications, in an effort to make people feel more comfortable about considering and using them. Advocates are eager to talk about how medication changed their lives, helped them get to therapy, helps them stay stable even in the face of adversity, has kept the monsters at bay. There’s a strong emphasis on the good things about medication, and much masking of side effects—sometimes, even, a willful desire to suppress discussion about those side effects, perhaps for fear that it might scare people off or validate the worst myths about medication.
Sometimes the dose is the poison.
It started with thirst. Not the low-grade, constant thirst I had grown accustomed to after years of taking a medication that causes thirst. An intense, unslakable thirst, downing liters of water with no appreciable difference, stomach taut and swollen, but still thirsty, dreaming of water when I slept, waking up fumbling for the water bottle I kept by the bed. Mouth hot and dry, prickly. I didn’t want to eat, maybe because my stomach was so full of liquid, but maybe because of the fact that my entire body felt like it was in open revolt. I got dizzy, heard ringing in my ears, felt faint.
Something is wrong here, I told myself as the tremor that had started over the summer with a constantly shaking, twitching hand that flapped uselessly against the keyboard and accidentally ripped the pages out of books. It grew more pronounced and spread to my whole body, which jerked randomly and spasmodically, jaw clacking or leg jumping. While driving. At a meeting. While cooking. I slopped boiling water on my foot and looked down with interest as my skin reddened and blistered. Then the vomiting started, on top of visiting the bathroom constantly to pee, having to game every trip out of the house carefully to avoid being caught out, and sometimes I failed at that. I put a pad in front of the toilet to make it easier on my knees, and between bouts I would lie on the couch, hair matted and sweaty, wondering what was happening to me.
I have not been, historically, the kind of person who develops side effects; that laundry list of unwanted events has been largely irrelevant to me. In fact, sometimes medications don’t seem to work on me at all; I have yet to encounter an opioid that does anything more than make me care slightly less about pain, not even the fentanyl nurses and doctors kept pushing in the recovery room after my last surgery, for an unrelated matter, in 2017. It took me a moment to realize that this thing, this constellation of miseries that made me want to claw my way out of my body and disappear into the darkness, bobbing away on the waves, was a reaction to medication.
Side-effects happen. Especially if you’re adjusting your dosage, which I was. But I am so acculturated to conversations about psychiatric medications that elide side effects and bury truths that it took me over a week of severe symptoms, so notable that even friends were commenting that something seemed off, to connect the dots, to go to the hospital, where the white-haired ER doc, a contractor, because that’s all they use these days, said I was in kidney failure because the medication had overcome my body’s ability to cope, gave me drugs for the vomiting and the tremor, and told me to talk to my
psychiatrist.
That tremor is the medication’s little gift to me: It will never go away, and whenever I do go off this medication, when it stops working, which psych meds often do, I’ll have to keep taking a different one for the tremor. Maybe if I had known in June what I discovered in September, I wouldn’t have been left with such severe damage.
The medication’s left me other gifts, ones I could return (I kept the receipt) if I stopped taking it: I am slower than I used to be. I have trouble with deep critical reading, sometimes reading the same passage over and over again and not understanding it. Oddly, I am more impulsive than I used to be, not less, as though my brain has lost a fundamental filter that cannot be restored. I am less observant, a thing I try to turn into a joke, deflecting.
I am not as creative, a thing that seems to have become a bit of a third rail in conversations about psychiatric medications. It goes like this: For a long time, it was broadly accepted that medication “kills creativity” and that, by extension, “true” artists and creators couldn’t and shouldn’t be on medication, because it would fundamentally reshape their work, that in fact, it was being mentally ill that made people creative. People, rightly, pushed back on that, noting that it’s hard to create when you’re dead, or spinning out, or feeling overwhelmed by your brain, that medication doesn’t necessarily have to mean a dulling of the mind and it shouldn’t be described that way. Now, openly saying that one has become less creative as a direct result of taking psychiatric medication can be a dangerous proposition, something author Heidi Heilig explored in her essay “What We’re Born With and What We Pick Up Along the Way.”
It is not that my medication killed my creativity, or that managing my mental health with medication makes it impossible to do the work I care about, but that a medication designed to act on the brain acts imprecisely and can suppress certain cognitive activities in some patients, and I am one of them. And yes, there are often other options, some with less suppressive effects, but they’re not right for me personally—and patients should absolutely talk to their doctors rather than just suffering, which is something they may not know they can do in a society where admitting these side effects exist is taboo.
This is a tradeoff I have chosen to make, one where I am not as bright and sharp and creative as I used to be, one where developing a transcendent turn of phrase is a fight, not something casual and effortless. I like and value and miss those parts of myself, but I do not like constantly fighting with my brain, feeling wildly tossed like the blades of the dune grasses in winter storms.
Here is a thing I am not supposed to confess: I think about it, sometimes, tapering quietly back down again, letting my mind run free, ending the reaction between the drug and my brain.
Would I have taken the drug at the very start, knowing what came later? Yes, I would have, but I wish I had known, because I would have gotten treatment at the first warning signs, not when it was so severe that I almost had irreversible kidney damage. Refusing to acknowledge that side effects exist doesn’t mean they don’t happen, it just leaves people marooned without information to make informed choices; to take or not to take, to take a different medication, to get early treatment for side effects. There is nothing wrong with taking psychiatric medication or deciding it is not for you, for any number of reasons. There are no circumstances in which people should be compelled to take it.
We are trying a different formulation, and if that doesn’t work, we will try something else, and I will continue on the endless merry-go-round so many crazy people know well as one medication stops working, sometimes dramatically and dangerously, and another one takes its place.
And I will keep talking about side effects, because I am reactive, though not in the way people mean, and failing to be open about it is to set other people up for failure. So many ugly lies and myths swirl around the drugs we take to survive in our minds; when we unmask them, we must not also hide the truth.
Jia Tolentino
Kanye West’s Sunday Service Is Full of Longing and Self-Promotion and Love, Death, and Begging for Celebrities to Kill You and E. Jean Carroll’s Accusation Against Donald Trump, and the Raising, and Lowering, of the Bar
New Yorker
FINALIST—COLUMNS AND COMMENTARY
This is where pop culture and emotional frenzy meet. Not Jia Tolentino’s—her writing is cool and considered, though often withering—but that of a nation where musicians are sometimes mistaken for spiritual leaders, fans (or is that “stans”?) long to be brutally dispatched by their favorite celebrities, and presidents are accused of rape and no one really notices. The Ellie Award judges praised Tolentino for her “moral conscience and literary flair” while noting that her New Yorker columns “provide a persuasive and highly readable tour of the American psyche.” Now in her early thirties, Tolentino joined the New Yorker as a staff writer in 2016. Her first book, a collection of essays titled Trick Mirror: Reflections in Self-Delusion, was published in 2019. Since David Remnick was appointed editor in 1998, the New Yorker has won fifty-four National Magazine Awards, including three for Columns and Commentary, most recently in 2019 for the work of Doreen St. Félix.
Kanye West’s Sunday Service Is Full of Longing and Self-Promotion
On the first Sunday of 2019, Kim Kardashian West assumed a new position as the unofficial head of communications for a pop-up church experience called Sunday Service, which was created by her husband, Kanye West. She pointed her sixty million Twitter followers to a series of videos that she was posting on Instagram Stories; they showed a seemingly phosphorescent choir, in a large studio flooded with ultraviolet light, singing startlingly beautiful gospel renditions of songs by West (“Father Stretch My Hands,” “Lift Yourself”). “Just hearing music as our Sunday Service was super inspiring,” she tweeted later, adding “See you next Sunday” and a sparkle emoji. Every Sunday since, West has put on, and his wife has promoted, a small, invite-only musical gathering, sometimes held in a room saturated with monochrome light, sometimes in a verdant field in Calabasas. Attendees have included Katy Perry, Courtney Love, Rick Rubin, Diplo, Busy Philipps, and Tyler, the Creator. (Kardashian West’s sisters and their children come, too.) Choir members wear matching outfits, which look like the sweats that West makes for Yeezy, his high-end fashion line; every week, they put on a new color, forming a pulsing block of white or black or periwinkle or “pill yellow.” The entire effort has an extravagantly normcore and vaguely cultlike vibe. “There’s no praying,” Kardashian West told Jimmy Kimmel, on his late-night show. “There’s no sermon. There’s no word. It’s just music, and it’s just a feeling.” Her sister Kourtney clarified that Sunday Service is, in fact, a Christian thing.
Everyone who attends Sunday Service has to sign a nondisclosure agreement, but attendees seem free to share their experiences through Instagram videos. In one such video, you can—contrary to Kardashian West’s description—watch DMX leading a prayer. In March, Courtney Love posted a video of West performing “Jesus Walks,” a single from his début album, with the choir stomping and singing the song’s a-cappella hook. West sounded good—agile and alert and formidable—which came as a relief to many who have observed his behavior over the past few years with growing worry. Back in 2016, West canceled the second leg of his Saint Pablo Tour and was hospitalized. When he reemerged, he often seemed, if anything, more erratic than before and took to saying things like slavery “sounds like a choice.” Last June, he released a slight album, called Ye—a diminutive of Kanye—by flying a group of influential people to Jackson, Wyoming, for a listening party; on the way there, he made the album’s cover art, a photo of the Tetons with the phrase “I hate being Bi-Polar its awesome” scribbled on it in neon green. “I believe ‘ye’ is the most commonly used word in the Bible,” West said in an interview. It’s not, but you see where this is going.
God has always been all over West’s music—the gospel-adjacent soul samples, the ever-present sense of glory and revelation—in a way that alte
rnately suggests worship and subsumption. In “Jesus Walks,” he positions himself as a prophet as well as a supplicant. The hook samples the Harlem-based Addicts Rehabilitation Center Choir, and West invokes Christ’s ministry to all, regardless of their past or their station: “To the hustlers, killers, murderers, drug dealers, even the strippers / Jesus walks for them.” West has a blindingly vivid messiah complex; he also has an obsession with iconoclasm that has led him all the way to the idea that slavery was voluntary. A decade ago, he told an interviewer, “I don’t wanna fuckin’ be Christ-like. I want to be me-like.” Later, in an attempt to clarify his remarks, he said, “My entire life, being an African American, Christianity was forced down my throat.” In Love’s Instagram video, we hear West rap, “I hope this take away from my sins, and bring the day that I’m dreaming about / Next time I’m in the club, everybody screaming out”—”Jesus walks with me,” the choir chants. Love tagged the post “#kanye” and also “#jesus #god #calabassas #gospel #holyspirit #transcendent.”
* * *
West has suggested that Sunday Service will soon come to an end, but, on Easter Sunday, which was also the last day of Coachella, he held a drawn-out Sunday Service at nine a.m., on a sod-covered hill on the periphery of the festival’s campgrounds. The event was live-streamed, in an absurd fashion, through a peephole camera; watching it felt like wandering dizzily around a very luxe cult gathering with two paper-towel tubes glued to my eyes. The choir wore mauve and tramped up the hill in winding single file. As many people observed on Twitter, the morning’s aesthetic had a Teletubbies feel, and the choir resembled the Tethered from the movie Us. A dense crowd, fenced off from the performance, covered the surrounding grass.
The obvious explanation for Sunday Service is that it’s album promotion. Last fall, West announced a ninth album, called Yandhi, and he has performed two Yandhi tracks at Sunday Service. (West previously shifted his wife’s wardrobe from a colorful bottle-service aesthetic to sci-fi-style Yeezy neutrals. It’s easy to imagine him issuing monochromatic dress codes for a Yandhi tour.) In an interview with TMZ, West explained that Ye had been an act of “superhero rehabilitation,” meaning, presumably, that it was like the part of an action movie where the avenging champion retreats to his lair to regain his strength. On the Ye track “Yikes,” he calls his bipolar disorder a superpower; last December, he declared on Twitter that he could not make “dark fantasy level music” when he was taking meds. With Yandhi, he said, he was getting “fully back in mode, off of medication.” As for the MAGA hat he’d been wearing, he added, it “means I’m being me and I’m punk and I can wear whatever I want ’cause I’m a god.”
